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Lowering the risk of DVT

IF you had asked the average person on the street two years ago what Deep Vein Thrombosis was, it’s likely you would have received a blank stare for an answer.

Recent deaths due to Deep Vein Thrombosis (DVT) or Economy Class Syndrome as its been nicknamed, has catapulted concerns about this condition into the hearts and minds of travellers all over the country.

After all, if a seemingly healthy 26-year-old woman can be struck down and die from this condition, it could happen to anyone. Couldn’t it?

According to Dr Peter Burke, a travel doctor from the Perth Travel Doctor Clinic, some people are definitely at greater risk from the affliction than others.

And it’s not just those who travel for long periods, although this too is a factor that will, according to Dr Burke, also increase the risk.

“It’s definitely more common in a travelling time greater than 12 hours,” he said..

Dr Burke said things that would increase your risk would be:

* A family history of abnormal clotting.

* Pregnant travellers.

* Travelling after certain sorts of surgery or illness, particularly pelvic surgery or some gynaecological procedures.

* Travelling in a plaster cast, because they’re immobilised.

* Overweight travellers.

* Elderly travellers. Certainly those in their 50s and 60s are a bit more likely than those in their 20s and 30s.

“General speaking we see the condition more with age. But I wouldn’t put too much emphasis on that because we’ve seen a couple of conspicuous cases lately where very young travels have developed it,” Dr Burke said..

* Smokers, because smokers generally clot more easily.

* the contraceptive pill.

“The risk with the modern conceptive pill is much, much less than it was when it first came out in the 60s,” Dr Burke said.

The condition, however, isn’t accumulative. So those who think that racking up their frequent flier points will also up their chances of developing DVT are mistaken.

“It’s really just to do with a single long trip,” Dr Burke said.

He likens the increase in risk with the frequency of air travel to that of driving a car.

“The only statistical relationship there would be that if you drive a lot, your more likely to have an accident, simply because there’s more hours on the road,” he said.

The media frenzy over recent deaths due to the condition has left many people with very real concerns about its development during air travel, especially those travelling in economy class.

The lack of space provided for the cheaper fair travellers has been touted as one of the possible causes of the affliction.

So what exactly is DVT and what causes it?

“DVT is a clot in a deeper vein, a vein that you can’t feel. Usually in the legs, but it can also be in the pelvic veins,” Dr Burke said.

“They’re dangerous because those veins can travel to the lungs and that’s where the mischief starts.

“They cause a condition called pulmonary embolus or PE. And that just means a clot which has travelled, it travels to the lungs.

“If it’s a small one (clot) it can just make you short of breath and give you pleurisy pain. And if it’s a big one you can just drop dead.”

“It’s important to point out that it doesn’t have to be air travel. You can get the same phenomenon on long bus trips. What you don’t want is a long period of being sedentary.

“Now everyone has had the phenomenon of getting off the plane and finding their shoes don’t fit or they can’t get them back on. That’s a small element of blood pooling. That’s the thing you’re trying to avoid.”

But there are ways to avoid developing DVT while travelling. Taking heed of some very simple advice can really help. And you can do more than just kick your legs into the back of the person sitting in front of you all the way to London.

“I think the important thing to emphasis is the thing you’re battling is this thing called stasis. Which is letting blood pool in the extremities,” Dr Burke said.

“So you try to combat that by activity. Exercising your legs, walking around the plane if you can, wiggling your toes, massaging your calves.

“Drink lots of water before you get on the plane and in flight.”

Another method of combatting the problem is through compression stockings and massage.

“A good thing to do is to give your legs a bit of a squeeze while your travelling. Squeeze them tighter at the ankles and looser as you go up the legs,” Dr Burke said.

“This will encourage the flow of the blood.”

For the average person this activity will lower your risk of developing DVT during travel, but there are certain members of the community who fall into extreme high-risk categories and for these unfortunate travellers the tips suggested by Dr Burke may not be enough. In these extreme cases, patients can receive an injection before they travel to ensure their medical safety.

“There are certain groups of particularly high-risk people, say for example those who have had this condition before,” he said.

“We will see them before a flight and give an injection which will last all day and prevent this condition.”

Before you decide to race off to your local GP for an injection, Dr Burke warns that it’s not given out like candy. You really do need to be in a high-risk group, rather than simply a highly-paranoid one.

“If there are risk factors there then you could be considered a high-risk traveller. Whether you warrant using an injection would be a medical decision,” Dr Burke said.

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